Analysis Of The Feature Of Dermoscopy Used In Young Papular Seborrheic Keratosis And Verruca Planae

Objective:Seborrheic Keratosis(SK)is one of the most common skin tumors in clinical practice,occurring mostly in the elderly,when it has typical characteristics such as light brown to brown nodules on the papillary or scaly surface.Seborrheic Keratosis is easily diagnosed.When it occurs in young patients,especially papular seborrheic keratosis,its skin lesions are small and flat,and the surface is smooth.Similar to verruca planae(VP),it is often misdiagnosed as flat warts and mistreated.It is not only ineffective but also increases patient burden,so identifying papular seborrheic keratosis and verruca planae have important clinical significance.At present,dermoscopy has become a new type of non-invasive dermatological diagnostic technique.It is possible to observe image structures and characteristics that are not visible to the naked eye such as the lower epidermis and dermal papilla,and the corresponding relationship between these characteristics and the skin histopathology.Determined the sensitivity and specificity of dermoscopy diagnosis.At present,only a few foreign scholars have described the respective dermoscopic features of seborrheic keratosis and verruca planae,and there is a relative lack of research on the characteristics of the epidermis of papular seborrheic keratosis and its differential diagnosis with verruca planae Therefore,the purpose of this study is to observe the descriptive characteristics of derma lens depicting papular seborrheic keratosis and verruca planaes,and summarize the value and significance of dermoscopy in identifying papular seborrheic keratosis and verruca planae,For the identification of papular seborrheic keratosis and verruca planae by dermoscopy,to reduce themisdiagnosis rate of verruca planae.Methods:1.Collected 50 cases of clinically diagnosed papular seborrheic keratosis and verruca planae from the Department of Dermatology,The hospital from December2016 to August 2017,Take the dermoscopic examination after consent of the patient.2.Summarize the gender,age,skin lesion location,clinical basic damage,and color of the selected cases,describe the dermoscopic indications of each lesion,summarize the analysis of the occurrence of each dermatoscopic indication was analyzed to find out if there were any New dermoscopy indications.Results:1.Papular seborrheic keratosis: A total of 50 patients,89 lesions,18 males and 32 females,male to female ratio 1:1.78,mean age(33.42±7.48)years,mean duration(15.13±13.94)months There were 67 lesions in the face and neck and 22 in the trunk.The skin lesions were 48 light brown and 41 dark brown.89 lesions(27.0%)of miliary cysts,46(51.7%)of moth-eaten border,67(75.2%)of fissures and ridges,and23 brain-like structures in the lesions of 89 patients with papular seborrheic keratoses.(25.8%),44 fat fingers(49.4%),33 comedo-like openings(37.1%),and 29 hairpin vessels(32.6%).In addition,we found a total of 51 homogenous network pattern(57.3%).There were 11(12.4%)papillary hyperplasia-like structures and 9(10.1%)pepper-like structures.2.verruca planae: A total of 50 patients,84 lesions,16 males and 34 females,male to female ratio of 1:2.1,age average(27.22±9.75)years,mean course duration(11.42±10.96)months,lesions on the surface There were 55 necks and 29 trunk limbs.The skin lesions showed 17 skin colors,45 pink,22 red-brown.Among the 84 lesions of verruca planae,there were 17(20.2%)skin backgrounds,67(79.8%)pinkbackgrounds,and 62(73.8%)spotty haemorrhages.In addition,we found that there were 23 ring pigmented structure(27.4%),and there were 28 onion skin peelings(33.3%).Conclusion:The most predominant dermoscopic features of papular seborrheic keratosis(occurrence frequency >50%)were fissures and ridges(75.2%),homogenous network pattern(57.3%),moth-eaten border(51.7%).New dermoscopic features were comedo-like openings(37.1%),hairpin vessels(32.6%),milia-like cysts(27.0%),papillary hyperplasia-like structures(12.4%)and pepper-like structures(10.1%).The main dermoscopic features of verruca planae(occurrence frequency >50%)were pink background(79.8%),dot-like bleeding structure(73.8%).New dermoscopic features were ring pigmented structure(27.4%),onion skin scaling(33.3%),skin color background(20.2%).By comparing the characteristics of the epidermis of papular seborrheic keratosis and flat warts,we found that the difference between the two shows significant differences in the dermoscopy.This is important for the differential diagnosis of both clinical and debridement examinations.Differential diagnosis of keratoderma and flat warts.The inadequacy of this article lies in the need to further study the sensitivity and specificity of each feature under the dermatoscope.